1
|
Berman S, Brown T, Mizelle C, Diep T, Gerber MR, Jelley M, Potter LA, Rush P, Sciolla A, Stillerman A, Trennepohl C, Weil A, Potter J. Roadmap for Trauma-Informed Medical Education: Introducing an Essential Competency Set. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:882-888. [PMID: 36862618 DOI: 10.1097/acm.0000000000005196] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Research has established that trauma is nearly universal and a root cause of numerous health and social problems, including 6 of the 10 leading causes of death, with devastating consequences across the life course. Scientific evidence now recognizes the complex injurious nature of structural and historical trauma (i.e., racism, discrimination, sexism, poverty, and community violence). Meanwhile, many physicians and trainees grapple with their own trauma histories and face direct and secondary traumatization on the job. These findings substantiate the profound impact of trauma on the brain and body and why trauma training is critical to the education and practice of physicians. However, a critical lag remains in translating essential research insights into clinical teaching and care. Recognizing this gap, the National Collaborative on Trauma-Informed Health Care Education and Research (TIHCER) formed a task force charged with developing and validating a summary of core trauma-related knowledge and skills for physicians. In 2022, TIHCER released the first-ever validated set of trauma-informed care competencies for undergraduate medical education. The task force focused on undergraduate medical education so that all physicians would be taught these foundational concepts and skills from the outset of training, recognizing that faculty development is needed to achieve this goal. In this Scholarly Perspective, the authors offer a roadmap for implementation of trauma-informed care competencies starting with medical school leadership, a faculty-student advisory committee, and sample resources. Medical schools can use the trauma-informed care competencies as a scaffold to customize integration of curricular content (what is taught) and efforts to transform the learning and clinical environments (how it is taught). Using the lens of trauma will ground undergraduate medical training in the latest science about the pathophysiology of disease and provide a framework to address many of our greatest challenges, including health disparities and professional burnout.
Collapse
Affiliation(s)
- Sarah Berman
- S. Berman is a third-year psychiatry resident, Cambridge Health Alliance, Cambridge, Massachusetts; ORCID: https://orcid.org/0000-0003-1037-8798
| | - Taylor Brown
- T. Brown is a second-year emergency medicine resident, Beth Israel Deaconess Medical Center, Boston, Massachusetts; ORCID: http://orcid.org/0000-0002-1893-9142
| | - Cecelia Mizelle
- C. Mizelle is a third-year medical student, University of North Carolina, Chapel Hill, North Carolina; ORCID: http://orcid.org/0000-0003-4401-1927
| | - Thang Diep
- T. Diep is a youth engagement specialist, Center for the Pacific Asian Family, Los Angeles, California; ORCID: https://orcid.org/0000-0002-5256-0320
| | - Megan R Gerber
- M.R. Gerber is professor of medicine, Albany Medical College, Albany, New York; ORCID: https://orcid.org/0000-0002-8444-5554
| | - Martina Jelley
- M. Jelley is professor of medicine, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma; ORCID: https://orcid.org/0000-0002-7816-2865
| | - Laura A Potter
- L.A. Potter is a third-year medical student, University of California, Davis, Sacramento, California; ORCID: https://orcid.org/0000-0001-6912-9214
| | - Patricia Rush
- P. Rush is codirector, Center for Collaborative Study of Trauma, Health Equity, and Neurobiology (THEN), Chicago, Illinois; ORCID: https://orcid.org/0000-0001-9775-7541
| | - Andres Sciolla
- A. Sciolla is professor of psychiatry, University of California, Davis, Sacramento, California; ORCID: https://orcid.org/0000-0002-0713-2183
| | - Audrey Stillerman
- A. Stillerman is assistant professor of family medicine, University of Illinois, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-0713-2183
| | - Christopher Trennepohl
- C. Trennepohl is a second-year psychiatry resident, University of Illinois, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-1745-0908
| | - Amy Weil
- A. Weil is professor of medicine and social medicine, University of North Carolina, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-7671-0397
| | - Jennifer Potter
- J. Potter is professor of medicine, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-6221-8895
| |
Collapse
|
3
|
Abstract
This article argues that the epidemic of depression is to be understood alongside the normative conditions of self-realisation associated with the emergence of the new spirit of capitalism. In the new spirit of capitalism, active realisation of the authentic self is an institutionalised demand, which is expected to be converted into praxis. This is interesting in relation to the phenomenon of depression, as it means that contemporary depression may be understood, not as a clinical and subjective condition, but as a mode of action. What is applauded in today's society is precisely what depressive individuals lack – namely the ability to realise themselves in accordance with contemporary normative values. Thus, within present-day society, depression and the institutionalised/capitalist demands for self-realisation have become each other's antitheses.
Collapse
Affiliation(s)
- Anders Petersen
- Department of Sociology, Social Work and Organization, Aalborg University
| |
Collapse
|
5
|
Farina B, Ceccarelli M, Di Giannantonio M. Henri Ey's neojacksonism and the psychopathology of disintegrated mind. Psychopathology 2005; 38:285-90. [PMID: 16179816 DOI: 10.1159/000088447] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Accepted: 11/09/2004] [Indexed: 11/19/2022]
Abstract
The French psychiatrist Henri Ey developed his organo-dynamic theory of the mind function and consciousness 50 years ago incorporating Hughling Jackson's thinking, along with psychiatric and philosophical theorizations by Janet and Bergson. This model has not received the attention it deserved, but recent advances in neuroscience rekindled interest for Ey's theory. By overcoming the Cartesian mind-body dualism and treating the mind-body unit as an inseparable whole, this model opens the way for the integrated treatment of mental disorders. Ey's conceptualization of consciousness as being simultaneously both synchronous and diachronic anticipates current theories of consciousness (Damasio, Edelman, Mesulam).
Collapse
|